cf rabies management, clinical features, diagnosis.pptx

rabies all

1. Clinical feature

2. Clinical Manifestations A. Prodromal features :- • Fever • Malaise • Headache • Vomiting • Anxiety • Agitation • Pain / paresthesias at the site of exposure ( in 50- 80% cases ).

3. Encephalitic Rabies A. • Encephalitic ( 80%) : - Fever •   Confusion •   Hallucination •   Combativeness •   Seizures •   Autonomic dysfunction (Hypersalivation , goosef lesh , cardiac arrythmias , priapism) • Hydrophobia •   Aerophobia •   Late complications ( cardiac failure , respiratory failure , multi organ failure )

4.  Hydrophobia :-  Involuntary painful contractions of diaphragm , accessory respiratory , laryngeal muscles in response to swallowing f luids.  Dysfunction of infected brainstem neurons that normally inhibit inspiratory neurons near Nucleus Ambiguus resulting in exaggerated defense ref lexes that protect respiratory tract.  Pathognomic of rabies and absent in animals.  Aerophobia :-  Same features caused by stimulation from a draft of air.

5.  Presents as atypical encephalitis with relative preservation of consciousness.  Episodes of hyper excitability followed by complete lucidity ( as disease progress interval between them shortens )  Progress rapidly and coma followed within a day by death is rule unless course prolonged by supportive measures.  Difficult to recognise late in clinical course when progression to coma has occured.

6. B. Paralytic Rabies (20%) :-  Muscle weakness predominates.  Early & prominent f laccid muscle weakness often in bitten extremity & spreading to produce quadriparesis & facial weakness.  Sphincter involvement common.  Sensory involvement mild  Lacks cardinal features ( hyperexcitability , hydrophobia , aerophobia )